Individual provider Active NPI

Mark Adelman, M.D.

  • Vascular Surgery Physician
  • New York, NY
National Provider Identifier
1952395642
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
166804 Issued in NY
Practice address
530 1St Ave
6 F
New York, NY 10016-6402
Phone
(212) 263-7311
NPI assigned
Sep 8, 2005
Last updated
Dec 10, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 166804 NY Primary

Addresses

Primary practice location

530 1St Ave
6 F
New York, NY 10016-6402

Mailing address

530 1St Ave
6 F
New York, NY 10016-6402
Phone (212) 263-7311

Other identifiers 1

IdentifierTypeStateIssuer
01606275MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040812000109 NJ Practitioner - Vascular Surgery 6406828151 Reassigns benefits to 1 organization
I20080522000651 NY Practitioner - Vascular Surgery 6406828151 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
166804NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
New York University Current Accepting new patients
New York University CurrentSince Nov 17, 2010 Accepting new patients
New York University Vascular Surgery CurrentSince Sep 1, 2007 Accepting new patients
New York University Past Accepting new patients

Locations

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

530 1st Ave
#6F
New York, NY 10016
Phone (212) 263-7311

530 1st Ave
Fl 6
New York, NY 10016

530 1st Ave
Ste 6F
New York, NY 10016
Phone (212) 263-7311

550 1st Ave
Ste 6F
New York, NY 10016
Phone (212) 263-0441

14 Wall St
Fl 9
Wall Street, NY 10005
Phone (646) 501-3224

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1952395642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "address_2": "6 F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 1ST AVE",
            "address_2": "6 F",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100166402",
            "telephone_number": "212-263-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELMAN",
        "first_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "166804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01606275",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.